Progressive Decrease in N Acetylaspartate/Creatine Ratio in a Teenager with Type 1 Diabetes and Repeated Episodes of Ketoacidosis without Clinically Apparent Cerebral Edema: Evidence for Permanent Brain Injury

Recent data suggest that DKA may contribute to cognitive impairment in children with type 1 DM. We measured the NAA/Cr ratio in a teenager during and following 2 separate episodes of DKA without clinically apparent cerebral edema. The NAA/Cr ratio decreased during DKA and improved following recovery...

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Bibliographic Details
Published in:American journal of neuroradiology : AJNR 2010-04, Vol.31 (4), p.780-781
Main Authors: WOOTTON-GORGES, S. L, BUONOCORE, M. H, CALTAGIRONE, R. A, KUPPERMANN, N, GLASER, N. S
Format: Article
Language:English
Subjects:
Adolescent
Aspartic Acid - analogs & derivatives
Aspartic Acid - metabolism
Basal Ganglia - physiology
Biological and medical sciences
Blood Glucose - metabolism
Brain - physiopathology
Brain Damage, Chronic - diagnosis
Brain Damage, Chronic - physiopathology
Brain Edema - diagnosis
Brain Edema - physiopathology
Creatine - metabolism
Diabetes Mellitus, Type 1 - metabolism
Diabetic Ketoacidosis - diagnosis
Diabetic Ketoacidosis - physiopathology
Dominance, Cerebral - physiology
Humans
Investigative techniques, diagnostic techniques (general aspects)
Magnetic Resonance Spectroscopy
Male
Medical sciences
Miscellaneous
Nervous system
Pediatrics
Radiodiagnosis. Nmr imagery. Nmr spectrometry
Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)
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Summary:Recent data suggest that DKA may contribute to cognitive impairment in children with type 1 DM. We measured the NAA/Cr ratio in a teenager during and following 2 separate episodes of DKA without clinically apparent cerebral edema. The NAA/Cr ratio decreased during DKA and improved following recovery. However, the NAA/Cr value was lower after the second episode of DKA (1.76) than after the first (1.97). These findings provide support for the hypothesis that neuronal injury may result from DKA.
ISSN:0195-6108
1936-959X
DOI:10.3174/ajnr.A1829